The paper gives an account of the concept and significance of the people-oriented principle and explores its practice in hospital management,including adopting patient-centered humane management,intensifying job dedication,and enhancing the hospital's cohesive force and development potential.Patient-centered humane management includes adopting the system of no companions for the inpatients,respecting the patients and safeguarding their rights and interests,providing friendly and comfortable medical environments for the patients,managing in a scientific,rational and whole-course manner the diets of the patients,and offering quality medical services to the patients.

Firstly the paper expounds the fact that letting patients pick their doctors goes with the tide of social development: ①the connotation of medical quality determines the necessity of patients involvement; ②evaluation of medical quality has extended from self appraisal to social assessment; and ③the mechanism of letting patients pick their doctors conforms to the medical quality requirements of the times. Then the paper discusses the positive impact of letting patients pick their doctors on medical quality, including the choice of doctors by outpatients and the impossibility of doing so in medico technical and emergency departments or by inpatients. The paper also gives an account of the measures taken for safeguarding medical quality when adopting the practice of letting patients pick their doctors. Lastly the paper explains the boosting role of the practice and the difference between letting patients pick their doctors and letting them name particular surgeons for their operations.

After an account of the background to the practice of letting patients pick their doctors in the Third Central Hospital of Tianjin, the paper points out the positive impact of the practice, comments on the specific measures, and narrates the results that have been achieved. These include: ①enhanced awareness of self management on the part of the staff; ②increased cohesion of the hospital; ③higher efficiency; ④greater initiative on the part of the scientific and technical personnel as a result of the reform; ⑤social recognition of the reform; and ⑥a higher level of professional ethics building. Lastly the paper discusses the hospitals experience in adopting the practice of letting patients pick their doctors.

Objective To observe the application of ultrasound-guided femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) for patients undergoing hip fracture surgery.Methods 60 patients scheduled for hip fracture surgery undergoing LMA general anesthesia were randomly divided into 3 groups,20 cases in each group.Before transfer patients from bed to operating table,A group received dezocine 5mg iv,B group received fascia iliaca compartment block(FICB),C group received FNB combined with LFCNB.40mL of 0.375％ ropivacaine was injected guiding by ultrasound in B group and C group.The time of sufficient sensory block and awake,the dosage of propofol and remifentanil,MAP and HR at pre-block (T1),20min after block (T2),transfer bed (T3),LMA insert (T4),skin incision(T5),LMA remove(T6) and sober(T7) were recorded.Pain was assessed using visual analogue scale(VAS) pre-and post block.The incidence of using vasoactive drugs,agitation,pain and adverse reaction were also recorded.Results The time of sufficient sensory block and awake,the dosage of propofol and remifentanil in A,B and C groups were as following:A group (not measured),(20.3 ± 1.3) min,(835 ± 6.7) mg,(1 285 ± 18) μg;B group (i2.2 ±2.7)min,(13.3 ± 1.4)min,(610 ±9.9)mg,(835 ± 15) μg;C group (9.7 ± 2.4)min,(12.8 ± 1.5) min,(555 ± 6.5) mg,(785 ± 16) μg.The time of awake,the dosage of propofol and remifentanil in B group and C group were significantly lower than those in A group(F =2.62,2.41,2.45,all P ＜ 0.05).The time of sufficient sensory block in C group was lower than that in B group (p ＜ 0.05).The MAP and HR at T2,T3,T5 and T7 in A,B and C groups were:A group (115 ± 4) mmHg,(90 ± 8) beats/min,(135 ± 6) mmHg,(98 ± 8) beats/min,(104 ±6) mmHg,(87 ± 4) beats/min,(120 ± 5) mmHg,(88 ± 8) beats/min;B group (102 ± 3) mmHg,(81 ± 6) beats/min,(112 ± 5)mmHg,(82 ± 8)beats/min,(89 ±6) mmHg,(72 ± 3) beats/min,(100 ±6)mmHg,(76 ± 8) beats/min;Cgroup (100 ± 3) mmHg,(80 x 6) beats/min,(109 ± 6) mmHg,(83 ± 5) beats/min,(86 ± 5) mmHg,(70 ± 3) beats/min,(99 ± 5) mmHg,(75 ± 5) beats/min.The levels of MAP and HR in B group and C group were significantly lower thanthose in A group(F =2.25,2.85,2.87,2.91,all P ＜ 0.05).The VAS scores at T2,T3,and T7in A,B and C groupswere:A group (3.9 ± 0.7) points,(8.2 ± 0.3) points,(6.0 ± 0.8) points;B group (2.3 ± 0.4) points,(4.1 ±0.4) points,(2.2 ± 0.7) points;C group (2.1 ± 0.5) points,(2.4 ± 0.4) points,(1.2 ± 0.4) points.The VAS scoresin B group and C group were significantly lower than those in A group (2.36,2.82,2.88,all P ＜ 0.05).The VASscores at transfer bed and sober in C group were significantly lower than those in B group (F =2.32,2.38,all P ＜0.05).The incidence of using ephedrine/atropine,urapidil/esmolol,PONV,agitation,pain and incision pain in A,Band C groups were:A group 30％,30％,25％,25％,40％;B group 10％,10％,0％,0％,10％;C group 10％,5％,0％,0％,0％.The number of patients who required vasoactive drugs and adverse reaction in B group and C group were significantly lower than those in A group(x2 =7.58,8.81,9.11,9.11,8.89,all P ＜0.05).The incidence of incision pain at sober in C group was lower than that in B group(x2 =9.21,P ＜ 0.05).Conclusion The ultrasound -guided FNB and LFCNB can obviously shorten the onset time,reduce the dosage of general anaesthetic and maintain the stability of henodynamics during the perioperative period.It has effective analgesia during transfer of patients from bed to operating table and sober.

Objective To research the relationship between the gene polymorphism of serum amyloid A protein(SAA)1 and coronary heart disease(CHD).Methods By using PCR-RFLP and sequencing,the gene polymorphism of SAA1 of 183 patients with coronary heart disease and 152 healthy controls were analyzed.Result In the both groups 3 alleles(1.1,1.3,1.5)and 6 genotypes(1.1/1.1,1.1/1.5,1.1/1.3,1.3/1.3,1.3/1.5 and 1.5/1.5)were found.The frequency of 1.5 allele in healthy controls group was notably higher than that in CHD group(P

Objective To study the relationship between the reexpression of nestin protein and the expression of basic fibroblast growth factor (bFGF) protein in cerebral ischemia. Methods By using rat permanent cerebral ischemia as a model, immunohistochemical staining was used to observe the expression of nestin protein and the bFGF protein 1,3,7,14 and 28 days after cerebral ischemia. Results The number of nestin cells around the ischemic area increased 1 to 3 days after cerebral ischemia,but it decreased 7 days after cerebral ischemia. However, the number of bFGF cells around the ischemic area increased obviously 14 days after cerebral ischemia, but it decreased 28 days after cerebral ischemia. Conclusion Reexpression of nestin protein around ischemic cerebral tissues does not need the nourishment and susteinance of bFGF protein; nestin cells around ischemic foci are originated from astrocytes which replay the course of fetation.

Objective To analyze the influence of hepatosteatosis on pancreatic β-cell function in type 2 diabetes mellitus (T2DM).Methods A total of 213 subjects with T2DM from Metabolic Disease Hospital,Tianjin Medical University from January 2013 to December 2013 were included in the study.Non-alcoholic fatty liver disease (NAFLD) was diagnosed with abdominal ultrasonography.Patients were divided into two groups:T2DM with NAFLD and T2DM without NAFLD.ALT,AST,γ-glutamyltransferase,serum lipid,glycosylated hemoglobin A1 c (HbA1c),fructosamine,fasting glucose,insulin and 2 hours plasma glucose,insulin after 75g glucoseload were detected.The insulin resistance and β-cell function were assessed by HOMA-IR and HOMA-β.Results Among the 213 T2DM subjects,51％ (108 cases) were with NAFLD.The HOMA-IR [4.76 (2.83,7.21) vs 2.79 (1.76,4.37),P ＜ 0.05] and HOMA-β [49.18 (37.78,85.09) vs 29.50 (18.09,45.54),P ＜ 0.05] were significantly higher in T2DM with NAFLD than those in T2DM alone.Within subjects with T2DM and NAFLD,the HOMA-IR [6.28 (2.87,8.17) vs 2.95 (2.07,3.66) P ＜ 0.05] and HOMA-β [59.18 (37.78,85.09) vs 30.59 (28.56,34.49),P ＜ 0.05] levels were higher in subjects with normal liver function than those with abnormal liver function.Conclusions T2DM patients with NAFLD have severer insulin resistance than those without NAFLD.The β-cell function of those patients was compensatory increased,which was decreased in subjects with abnormal liver function.

Objective To develop a three-stage standardized and systematic training program framework and indicator systems for clinical midwives.Methods Based upon literature review,Delphi technique was used to formulate index system and indicators for midwives' training program through tworound expert consultation among 29 experts.Results After two-round expert consultation,the response rates were 96.7％ and 100.0％,respectively.Experts' authority coefficient was 0.874.The training program framework consisted of a three-level index system.Average importance scores of the three-level indexes were 4.10 to 4.97,4.07 to 4.97,and 4.00 to 5.00,respectively.And their variance coefficients were 0.037 to 0.119,0.037 to 0.130,and 0 to 0.141,respectively.Then a progressive and integrated three-year standardized training framework and index system for clinical midwives was finally formed,which totally contained 5 first-level indicators or training modules,including professional competence and safety awareness,specialized and basic knowledge,specialized practical skills,emergency management,and basic capacity for teaching and research.Conclusions The three-level framework and indicators for clinical midwives' training program has been proved to be acceptable,reliable and scientific,thus providing a theoretical and referential basis for training clinical midwives and improving teaching quality.

BACKGROUND:With the continuous development of nanotechnology, a growing number of nanotechnologies have been used in the field of biological medicine, providing a great deal of interest for the diagnosis and treatment of disease. OBJECTIVE:To review the research situation of nanobiomaterials and its application in biological medicine. METHODS: The articles about nanobiomaterials and nano bioceramic materials were retrieved from Chinese Journal Ful-text Database, PubMed and Wanfang database published during January 2000 to October 2014 by the first author using computer. Key words were “nano, bioceramics” in Chinese and English, respectively. RESULTS AND CONCLUSION: With the development of nanotechnology, some nanotechnologies have entered the stage of practical application. Application of nanotechnology plays a preventive effect to the occurrence and development of disease. Nano-ceramic significantly increases the strength, toughness and superplasticity of materials, overcomes many deficiencies of biological ceramics, and has been widely used in the field of orthopedics, such as artificial joints, artificial bones, bone filing material, bone replacement materials, artificial vertebrae and so on.

Phosphorylation is the most common way of p 53 post-translational modifications .However , gaps still exist in our knowledge regarding the role and mechanism of phosphorylation of p 53 at Ser392 in carcinogenesis and cancer prevention.In the present study, we summarized the effect of phos-p53-Ser392 to wild-type and mutant p53, the regulation by DNA damage agents and protein kinase , and the significance of phosphorylation of p 53-Ser392 in cancer treatment .